tci Medicare Compliance & Reimbursement - 2012 Issue 11

E/M Billing: OIG Targets Facilities That Bill E/Ms Which Should Have Been Included in Procedures

Save yourself from this potential minefield with these expert tips.If you see a patient in the hospital prior to his surgery, you typically can't count that toward reporting an E/M service -- instead, your pre-procedure check-in with the patient will be included in payment for the service you perform.Some hospitals, however, aren't aware of this rule -- and the OIG is watching. A recent audit of Georgetown University Hospital in Washington, DC revealed that 21 of 125 selected claims showed errors related to outpatient E/M codes being billed with other services.The E/M services "were not separately...

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